| NPI | 1578089678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P HUMISTON Owner 214-227-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2023-02-06 |